Dr. A.J. MORGAN
Dear Readers,
A.P is a 51-year-old woman from Kingston 6 who is plagued with hot flashes. She notices that there are times when she is very hot and sweating while other people seem to be cool and unaffected by the heat.
She last saw her period (menses) in June 2000. She often seems to lack energy, is irritable and cries easily. She knows she is going through her "change-of-life" and asks if anything can be done to make this experience more bearable.
The "change of life" or menopause refers to the cessation of the menses and actually, occurs on average at about 51 years of age.
For about 10 years prior to the menopause ovarian function begins to fall off. Ovulation occurs less frequently and oestrogen hormone production by the ovaries progressively decreases. One of the earliest symptoms of approaching menopause is disturbance of the menstrual pattern with irregularity of the periods and either increased or decreased amount of blood flow.
Hot flashes and sweats occur in most women. These symptoms are most severe in women who have sudden cessation of periods and withdrawal of hormonal production when surgical hysterectomy and oophrectomy (removal of the ovarians) is performed.
Hot flashes are wave-like sensations which move up the chest to the head and are associated with profuse perspiration and flushing.
This sensation can last anywhere from a few seconds up to an hour. Anxiety, depression and irritability are also frequent in the perimenopausal years (near change of life) as are more minor complaints of headache, fatigue and sleeplessness.
Hormone Replacement Therapy (HRT) can be of great benefit for women with symptoms associated with the menopause and those who are at risk of osteoporosis (thinning of the bones), and heart disease. However, use of HRT must be assessed for each woman individually. HRT is not suitable for every woman. The loss of the female hormone, oestrogen, which results from ovarian failure causes a decline in general health, and in the quality of life as well as increases the risk of osteoporosis, heart disease and Alzheimer's disease.
Replacing the lost oestrogen relieves the hot flashes, the depression and loss of memory and helps with concentration. Use of HRT has been proven to prevent osteoporosis, and reduce the occurrence of heart disease and stroke. Hormone replacement in older women reduces the incidence of colon cancer, reduces tooth decay, reduces dryness of the skin and vagina, improves balance and reduces falls. It even improves wound healing. There are few absolute contraindications to the use of HRT.
All women must seriously consider the use of HRT at the time of menopause as it improves the quality of life in the patches placed on the skin, by monthly injections, vaginally and even by using gels and implants. There are few risks taken by its use and these are:
1. Slight increase in the incidence of thromboembolism (blood clots)
2. Slight increase in breast cancer in women who use HRT for more than five years.
3.Slight increase in Endometrial cancer in women who do not use combined oestrogen and progestogen hormonal replacement therapy.
These risks are almost nullified by the improvement in the quality of life and health experienced by literally all users of HRT.
Do you have a health question? Write to Lifeline, c/o THE STAR, 7 North Street, P.O. Box 40, Kingston.
